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Norman B. Smith was diagnosed with inoperable liver cancer by his doctor at LA's Cedars-Sinai Medical Center, who prescribed medical marijuana. Now, Cedars-Sinai has removed Mr Smith from the list of liver-transplant candidates...because he tested positive for marijuana, which their own doctor prescribed.

Hospital officials are insisting that Smith stop using marijuana for at least six months, undergo random drug testing, and participate in weekly substance-abuse counseling before they will consider putting him back on the list.

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Did this doctor have no idea of their own rules? or was the doctor trying to intentionally bump Mr. Smith off the list?

I have a friend on the liver transplant list. He’s a Kaiser patient and has a primary physician in Palm Springs, where he lives. The actual liver transplant unit is at UCLA. Kaiser has a liver transplant management service at Kaiser LA. His primary physician, the person who manages his liver treatment and the people who would actually do the transplant are at three different locations. Get the picture?

For the record there is a medical reason behind these refusals, marijuana can harbor certain fungal spores that, if smoked by an individual with an immune system suppressed by transplant medicines, can cause life (and transplanted organ) threatening infections. As I understand it marijuana can be processed to kill these spores and still be safely used by such patients. Some transplant centers insist on these guidelines, while others do not. An additional rationale relates to the use of any substance by a liver transplant patient, since the need for liver transplant is sometimes due to cirrhosis caused by alcohol abuse.

So, they are worried about life threatening infections due to a spore present in marijuana, but less worried about the deadly infection you are more likely get just by being operated on in a hospital? Sounds legit.

Drugs. Ok as long as big Pharma dolls them out, bad if you grow it yourself.

There is incredibly scant evidence that marijuana has enough aspergillus spores to be a threat. There is only one study that even makes an attempt to measure CFUs of aspergillus from marijuana samples (and you could certainly raise some questions about its source — indoor or outdoor? imported or domestic?) I spoke to someone who works with a lot of AIDS patients that use medical mj and he said he’s never, ever seen a case of invasive aspergillosis. And you’d think that people with heavy immune suppressions would get it, if any population would.
Certainly, there are enough questions that this sort of thing should be tested for more broadly, especially in dispensaries. There are a handful of case reports of cancer patients on pubmed getting aspergillosis from marijuana, but what’s conspicuous by its absence is any systematic study. these are simply case reports, and that’s literally all there is. out of the thousands of people who get cancer every year and have so, theres like 5 instances of this happening.
And then add to that fact that a UMich group recently did a study on the OTHER major rationale for denying livers to med mj patients, drug-regimen adherence. they didnt find any evidence to suggest that med mj users were less adherent than any other patient.

Hey, now. Don’t use actual studies and lack-of-studies as evidence that perhaps this “marijuana is evil and causes fungus!” bullshit is … bullshit! Bad rageaholic, bad! We wouldn’t be able to justify the War on Drugs any longer if we used logic and common sense!

Marijuana can’t be processed to kill aspergillus spores once they’ve formed, however the spores will only grow in the first place if the crop hasn’t been grown and cured properly. It’s also very easy to detect if it has formed.

This is precisely the sort of reason the world would be better off with legalised and properly regulated drugs, rather than having a criminal underworld in charge of all of this stuff. Think the average grower that’s risking his ass to move a few pounds is going to destroy a couple of grand worth of crops because he detects a tiny bit of mould forming? Hell no, they’ll get rid of buds that are obvious, make sure the rest is dried out (likely still harbouring the sometimes dangerous and invisible spores that have fallen off the other mouldy bits) and move that shit along. Think a company/shop/dispensary that isn’t risking their ass until they sell buds could get them sued are going to behave like that?

The same problem existed during the prohibition. People didn’t really know what they were doing and as a result booze could easily be tainted with methanol.

Neither the aspergillus spores, nor the methanol were/are a great danger in the scheme of drinking or smoking pot, but in the case of ending the prohibition the risk ended pretty much entirely and exactly the same would happen if pot was legalised and controlled properly.

It’s been pretty much debunked by rageaholic above. More than likely, your wife and those she works with and other medical personnel go with the fungal thing “Just in case” or because “someone, somewhere said it might be a problem”, without any real solid evidence.

A liability thing, really. Which makes sense when you get down to it and I understand the reasoning (no one wants to get sued), but I’d rather have these kinds of policies based on actual science research, not conjuncture.

I thought it was only us Brits who had Death Panels?!?!I thought the US medical system allowed everyone to have all the treatment they could ever imagine without some petty bureaucrat telling them what they could or couldn’t have and deciding that they should die.

Don’t tell me that a charity or commercial concern can have the kind of idiotic and kafkaesque rules and regulations that only a Government can create?

So, now they’re giving the death sentence to pot smokers. The war on drugs is way out of hand.

I’m sure Peter McWilliams, best-selling author and civil rights advocate for the decriminalization of “victimless crimes” would agree with you … or at least he would have, had he not drown in his own vomit when the cops told him they would take his mother’s house if he continued to use MJ to control the nausea brought on by a medical condition.

Funny how nobody demonized my Dad when he got three screws in his thighbone for having first an opiate drip of some sort, and then, upon discharge, oxycontin 4x a day even though smack and oxy are MUCH more dangerous drugs than weed. And they didn’t come over to his house and threaten to discontinue his physical treatment unless he poured his substantial booze stash, erm, well-stocked bar, down the toilet and enter “counseling.”

Point #2 re “infections.” I now work at a major healthcare center, and transplant patients get visitors all the time–seeing their grandchildren, kids, etc just “one last time” because they don’t know when the last time may be if they’re really doing badly. Little Suzie bringing Grandma a picture from nursery school probably exposes Gran to 1000x more pathogens than a puff of reefer, which IIRC has a very high burning temperature anyway (me no smokey da whacky tabaccy myself, so I’m going on what I’ve heard).

The hypocrisy is astounding.

FYI my Mom has major rheumatoid arthritis and long-improperly treated joint injuries. She also has quite a green thumb. I wish she was just a little less law-abiding; I have no doubt that Mom could grow some killer shit for herself to have as tea (has asthma too) and would feel much better, as her Motrin is burning a hole in her stomach.

Now he has to participate in substance abuse theater? I bet the counselor will be just as embarrassed (“Here, sign in, sit in the back, and have some coffee. Feel free to read until we’re done”). Between this and our airport security song and dance routines we really love superficial mandatory acts in this country.

inoperable probably means, in this context, that “we can’t resect [cut out] the tumor and leave you with enough liver to function” but not “we can’t even give you another liver”

also, I want to point out that because of the CA laws, (at least last I checked), a doctor doesnt have to “prescribe” something for their patient to get medical marijuana. they only have to state that they do NOT OBJECT to their patient using marijuana to treat their condition(s). fairly big difference there, but it means that his doctor may not have prescribed it for him to be a med mj patient.

my knowledge of CA med mj laws is about 3-4 years out of date, so things may have changed in that time.

Just thought I’d point out that marijuana can be ‘recommended’ but never ‘prescribed’. Prescribable medicine requires federal approval but unfortunately the feds keep marijuana on the list of drugs with no known medical benefit.

They Gave mickey Mantle a new Liver one day after it was determined that alcoholism had destroyed his first one. Very short list.

He died a couple months later.

Sometimes for outsiders there is no rime or reason to how/what happens in the medical profession.

Everyone jumped on Meg about wishing the organ went to a kid instead of an old guy. This too is a hard choice to make. Kids are stronger than old people and in many cases can wait longer to get a transplant.

And if I understand liver transplants correctly even if they had a liver that matched a kid and this guy you don’t need to give either the entire organ. The liver is one of the few organs that can regrow so you can give them enough to keep them stable to start.

What is the medical basis for this denial? I mean, is there some evidence that smoking pot will reduce his chances of a successful transplant? Or, is this simply political. Is this man going to die for political correctness?
I know studies have shown nicotine to increase the rate of rejection and death but where is the same scientific evidence for pot? Also, I saw someone post about fungal spores from smoking. Fine, how about eating marijuana? Another question is substance abuse. I believe we can eliminate this since this is a prescribed treatment.
I’m questioning the scientific bona fides here. Without evidence this man will be sentenced to death based on speculation rather than facts.

Fungal spores just as, or more dangerous when eaten. However as I stated earlier its a very low risk problem even when buying weed from the average illegal supplier and would be an even lower risk from a medical marijuana dispensary.

Itsumishi,
Cooked marijuana is almost always what is called canna-butter. The flower is cooked in butter to extract the canniboids. The green material is strained and discarded. Fungus does not survive this process.

The fungus itself might not, but fungal spores do survive the process. They survive temperatures well above burning, well below freezing and are microscopic and many will get through any straining process.

You’ll cut the number of spores considerably, because plenty would be trapped in the green material you’re straining but a fair amount will be in the butter itself.